sports and allergy

Hives and Anaphylaxis

Many people experience hives when they exercise. This disorder can be diagnosed by the appearance after exertion of itchy wheals, often small, and often in association with perspiration. Exposure to heat causes similar symptoms in affected individuals. Antihistamines are effective in relieving symptoms.

Perhaps the most serious, though fortunately rare, allergic disorder associated with sports is exercise-induced anaphylaxis (a life-threatening condition where the body stops functioning). After exertion, anaphylaxis symptoms can suddenly emerge. Typical symptoms include itching, hives, wheezing, and hypotension. Exercising within four hours after a meal seems to increase the likelihood of an attack. In some individuals, ingesting specific foods (celery, wheat, and tomatoes, among others) may increase the chance of a reaction. Preventive medication is not helpful; these individuals should tailor their activity to avoid triggers and should carry an emergency epinephrine syringe.

Other Hazards

Allergic sports participants face additional concerns with some activities. The high air pressures associated with scuba diving create risk for people with chronic sinus disease or asthma. Skiing at high altitudes can also cause ear and sinus pain in individuals with allergic mucosal swelling. Equestrians may actually be allergic to their equipment (containing horse dander and dust). Many sports participants take nonsteroidal anti-inflammatory drugs (such as aspirin or ibuprofen) for muscle soreness, and these medications can worsen rhinitis and asthma in some individuals.

Allergy Evaluation

Involvement in sports carries many behavioral and physical health benefits, and nearly all individuals who experience allergies can be helped to participate fully. Many of the problems associated with allergies in sports can be effectively treated by your primary-care physician. For individuals who do not respond easily to therapy, further evaluation by an allergist can help detect and deal with specific triggers. Skin tests and radioallergosorbent tests for allergens, controlled food challenges, and provocative bronchial challenges are some of the specialized tests that are available.

Source:Bruce Ryhal, M.D., Allergies and Asthma in Sports